Clinicopathology of recurrent hepatocellular carcinomas after radiofrequency ablation treated with salvage surgery

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URI http://shark.lib.kagawa-u.ac.jp/kuir/metadata/27474
Title
Clinicopathology of recurrent hepatocellular carcinomas after radiofrequency ablation treated with salvage surgery
File
Description

Abstract
AIM:

Radiofrequency ablation (RFA) is an effective standard local therapy for small hepatocellular carcinoma (HCC). However, local recurrence and/or tumor seeding after RFA remain major problems. For better understanding of underlying factors, we clarified clinicopathological features of recurrent HCC treated with RFA.
METHODS:

This retrospective study included 21 patients who underwent surgical resection for HCC disease recurrence after RFA. Clinicopathological findings, including patterns of recurrence, immunohistochemical expression of proliferation markers (Ki-67 and p27(Kip1) ) and survival outcome were assessed.
RESULTS:

The median time interval after RFA until the diagnosis of intrahepatic and/or extrahepatic tumor progression was 12 months (range, 3-84). Radical surgical resection was attempted for intrahepatic local recurrence in 16 patients (18 lesions), for peritoneal dissemination in four, for lymph node metastases in three and for adrenal metastasis in two. In 14 of the 21 (67%) patients, the recurrent HCC were histologically diagnosed as of poorly differentiated type. Their average Ki-67 and p27(Kip1) labeling indices were significantly higher (P = 0.020) and lower (P < 0.001), respectively, compared with values for the 108 HCC surgically resected at the initial treatment. Portal involvement was significantly higher (P = 0.01) in recurrent tumors after RFA (72%) than in HCC surgically resected at the initial treatment (43%). The mortality rate of salvage surgery was 0%, with cumulative survival rates at 1 and 3 years of 58.9% and 35.7%, respectively.
CONCLUSION:

The recurrent tumors after RFA have characteristics of poor differentiation degree and abnormalities in cell-cycle regulators and are associated with aggressive vascular invasiveness.

KEYWORDS:

cell cycle; hepatocellular carcinoma; radiofrequency ablation; recurrence; surgery

(医博甲591)

Author
著者 山本 尚樹
著者(ヨミ) ヤマモト ナオキ
著者(別表記) Yamamoto Naoki
Publication Title
Hepatology Research
Publication Title Alternative
Hepatol Res.
Volume
44
Issue
11
Start Page
1062
End Page
1071
Publisher
Japan Society of Hepatology
日本肝臓学会
Wiley
Published Date
2013-09-18
ISSN
1386-6346
NCID
AA11140867
PMID
23957810
DOI
10.1111/hepr.12223
Resource Type
Thesis or Dissertation
Language
eng
Resource URL
https://doi.org/10.1111/hepr.12223
Text Version
none
Grant ID
博甲第591号
Grant Date
2014-03-24
Degree Name
博士(医学)
Grantor
香川大学
Set
香川大学
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